University of Craiova

Background/Objectives: Hepatitis E virus (HEV) infection is an increasingly recognized cause of acute hepatitis in Europe, but short-term in-hospital laboratory dynamics remain insufficiently described in hospitalized cohorts. We aimed to characterize admission biochemical abnormalities and paired admission-to-discharge laboratory changes in hospitalized patients with acute hepatitis E from Craiova, Romania, with exploratory sex- and age-stratified analyses. Methods: We conducted a single-center retrospective observational study including 40 consecutive hospitalized patients with acute hepatitis E during 2024-2025. Admission and discharge laboratory values were compared at the within-patient level, and exploratory subgroup analyses by sex and age class were performed. Given the limited sample size, multivariable analyses were restricted to parsimonious age-adjusted models for selected endpoints. Results: The cohort comprised 22 females (55%) and 18 males (45%), with a mean age of 53.05 ± 21.44 years; two in-hospital deaths occurred. At admission, marked transaminase elevation and frequent hyperbilirubinemia were observed, with 70% of patients having total bilirubin ≥ 2 mg/dL and 40% ≥ 10 mg/dL. During hospitalization, ALT and AST declined markedly, whereas total and direct bilirubin improved more modestly, indicating slower resolution of jaundice/cholestatic abnormalities. Platelets increased, while prothrombin index changes were heterogeneous. Male patients had higher bilirubin values at admission and discharge and more frequent clinically relevant hyperbilirubinemia thresholds; however, these findings should be interpreted cautiously given the small sample size, the retrospective design, and the absence of standardized clinical confounders and mechanistic data. Exploratory age-stratified analyses did not identify robust differences after multiplicity control. Conclusions: In hospitalized hepatitis E, hepatocellular injury markers improved rapidly during hospitalization, whereas cholestatic abnormalities resolved more slowly and often remained clinically relevant at discharge. The observed sex-related cholestatic pattern should be considered exploratory and requires confirmation in larger studies with standardized clinical covariates and longer follow-up. These findings support closer monitoring of bilirubin trajectories at discharge, particularly in male patients, and highlight the need for integrating laboratory dynamics into short-term clinical assessment of hospitalized HEV cases.

Medical oncology is a young specialty in Romania, where early-career oncologists face challenges related to training, mentorship, and research. This study explored their professional status and needs to inform workforce development. An online survey was conducted between February and April 2025 among physicians under 40 years of age who were members of the Romanian National Society of Medical Oncology (SNOMR). The questionnaire (60 items) covered demographics, employment, mentorship, research, and professional development. Descriptive analysis was performed. Of 456 eligible members, 169 responded (response rate: 37%). Most were residents based in oncology institutes or university hospitals. Job insecurity was common, with 57% on temporary contracts. Nearly all respondents (99%) had clinical duties, but only 21% engaged in research and 9% in teaching. Mentorship was inconsistently available (61% had a mentor), yet interest in structured programs was very high (88% for national and 87% for international initiatives). Research involvement was limited: 46% reported no activity, 85% lacked funding, and only 28% published in the past year. While over 80% expressed interest in fellowships or exchanges, only 16% had trained abroad. Most (85%) were ESMO members, but only half considered SNOMR support sufficient. Young oncologists in Romania are motivated but face significant barriers, including job instability, insufficient mentorship, and limited research opportunities. Expanding structured mentorship, ensuring protected research time, and strengthening international mobility are essential. Recent SNOMR initiatives represent important first steps toward addressing these gaps.

Background and Objectives: When a single missing tooth must be replaced, the best solution is the placement of an implant. In adults, most of the time the space for implant is totally or partially closed due to the shift in the adjacent teeth. The objective of the study was to describe the clinical parameters, treatment choices, and outcomes associated with orthodontic space opening for single-tooth implants in various treatment solutions, as well as to determine their influence on the variation in the dimension of the edentulous space. Materials and Methods: An observational prospective cohort study was designed in which patients with a single missing tooth were selected to be included in the study. After the clinical examination two groups were formed: patients who opted for fixed orthodontic treatment (metallic or sapphire) to open space for implant and patients who opted for alignment to achieve this (with Invisalign or Spark). All subjects received orthodontic treatment. A dental chart was created for each patient which included demographics, clinical data, orthopantomography (OPG), profile cephalograms, and photographs. The potential implant prosthetic space was measured during orthodontic treatment to observe the space dimension evolution in time. Results: In total, 97 patients were included in the study, 60 women and 37 men, with ages between 14 and 60 years. Edentulous spaces dimensions were opened from 1-4 mm to 5-6 mm (39.18% patients), 6-8 mm (48.45%), and >8 mm (12.37%). Both types of orthodontic treatments were effective in opening the potential prosthetic space for implant. Conclusions: Large prosthetic spaces and older edentulism tend to require longer treatments. Older patients had experienced edentulism for a longer period, indicating a correlation between age and the duration of tooth loss. Metal fixed orthodontic appliances were used in exceedingly long treatments, while aligners/sapphire brackets were used in short-medium durations. For the study group, fixed appliances and aligners proved to be effective in opening the space for future implants.

Ultra-processed foods (UPFs) represent a distinct dietary paradigm characterized by structurally simplified food matrices and chronic exposure to multiple additives, including emulsifiers, artificial sweeteners, and preservatives. Rather than acting in isolation, these compounds operate within a multi-additive environment that reshapes the gut ecosystem through convergent mechanisms. Emerging evidence suggests that additive-rich ultra-processed dietary environments may disrupt the gut ecosystem through three interconnected layers: (1) structural impairment of the intestinal barrier, including mucus erosion and tight-junction destabilization; (2) microbial metabolic shifts marked by short-chain fatty acid depletion, altered bile acid signaling, and enrichment of lipopolysaccharide-producing taxa; and (3) immune and inflammatory reprogramming promoting low-grade systemic inflammation. These processes collectively reduce ecosystem resilience-the capacity of the gut microbiota to resist and recover from perturbation. Vulnerability to additive-driven dysbiosis varies across the life course. During infancy, incomplete ecosystem stabilization may increase susceptibility to long-term ecological imprinting, whereas in older age, reduced microbial diversity and immune remodeling may impair recovery capacity following dietary stressors. In contrast, fiber-rich, minimally processed dietary patterns appear to enhance microbial resilience by reinforcing functional redundancy, metabolic buffering, and barrier integrity. Although much mechanistic evidence has been derived from experimental models, accumulating human data support the biological plausibility of additive-associated microbiota alterations. By integrating multi-additive exposure, ecosystem disruption, life-course modulation, and resilience within a unified framework, this review provides a mechanistically coherent model linking ultra-processed dietary environments to microbiota-mediated chronic disease risk. Here, we formalize this integrative perspective as the Three-Layer Ecosystem Disruption (TLED) Model.

The control systems for models described by non-commensurate fractional-order differential equations are based on their transformation into large commensurate-order systems, which impose difficulties in determining control laws. In this context, in this paper, a new control method for this class of systems is proposed. The results obtained are based on Lyapunov methods for differential equations with fractional exponents and on the application of the Yakubovich–Kalman–Popov lemma adapted for this class of systems. The stability criterion is presented as a frequency criterion and represented graphically by familiar frequency plots similar to those of the Nyquist or Popov type. If the parameters that define the model can be defined in a closed domain, the frequency criterion can be interpreted as “Popov’s circle criterion”. The two numerical applications present two important cases. The first studies the stability criterion in the case where the viscosity coefficients determine non-commensurate fractional-order exponents in the dynamic model of the system. The second example studies the complex problem of the human–machine system in which the human model imposes dynamics determined by non-commensurate fractional-order systems. The proposed investigation methods allow for a reduction in computational effort by several orders of magnitude for non-commensurate fractional-order systems, eliminate stability conditions that use matrix-based criteria for large-scale systems, and introduce standard frequency-domain criteria.

Visionary literature is a topic that has only been explored to a very small extent and only tangentially. Extensive studies, theorization, definitions and classifications are necessary to fully understand the phenomenon. It has often beensaid that Nichita Stănescu’s poetry is a visionary poetry, but no dedicated study has been conducted. This article identifies the types of visionary corresponding to the lyrical stages. Edenic visionary is a characteristic of the early poetry collection and it refers to a universe that recalls the purity, harmony, and perfection of beginnings.Gnostic visionary is found in the lyrical maturity stage when the lyrical self becomes reflective and aware of the passing of time. In the final stage, metaphysical visionary is observed in the self’s retreat into itself and the exploration of the universe beyond reality. All of these fall under the umbrella of ontological visionary because Stănescu’s poetry is concerned with defining being and existence, the relationships between things and the processes that control existence.

Background: Advanced stages of peripheral arterial disease, particularly chronic limb-threatening ischemia, are characterized by unfavorable limb outcomes and a substantial risk of major amputation. Clinical evaluation traditionally focuses on arterial obstruction; however, venous dysfunction may coexist and contribute to local limb pathophysiology in advanced PAD, remaining insufficiently recognized in routine practice. Methods: We performed a retrospective cohort analysis of consecutive patients with advanced peripheral arterial disease managed at the First Surgical Clinic of the Emergency County Clinical Hospital of Craiova over a five-year period (January 2020 to December 2024). Venous disease was defined using a clinically oriented composite definition incorporating imaging-confirmed venous pathology, prior deep venous thrombosis, and persistent lower-limb edema attributable to venous dysfunction. Arterial disease severity was assessed using multimodal imaging. Analyses were performed at both patient and limb levels to evaluate associations between venous disease, arterial severity markers, and clinical outcomes. Results: Among 241 patients (482 limbs), concomitant venous disease was identified in 68.9% at the patient level and was predominantly unilateral. At the limb level, venous disease was significantly associated with markers of severe arterial involvement, including inflow disease, higher segment occlusion scores, impaired tibial runoff, and absence of a patent pedal arch. Despite greater arterial severity, patients with venous disease exhibited a lower unadjusted rate of major amputation compared with those without venous involvement. Conclusions: Concomitant venous disease is highly prevalent in patients with advanced PAD and is closely linked to arterial disease severity. These findings suggest that venous dysfunction represents an integral component of advanced limb-threatening ischemia rather than an isolated comorbidity. Incorporating clinically oriented venous assessment may improve understanding of limb pathophysiology and support a more integrated arterio-venous approach to advanced PAD management.

Background/Objectives: Accurate nuclear segmentation is a fundamental step in computational pathology, enabling reliable estimation of cellularity and nuclear morphology. However, segmentation models are typically evaluated under ideal imaging conditions, while real-world microscopy data are affected by staining variability, noise, and image degradation. This study aims to comparatively evaluate three representative convolutional architectures for nuclei segmentation, with emphasis on robustness and clinical relevance under perturbed imaging conditions. Methods: U-Net, Attention U-Net, and U-Net++ were trained and evaluated on the BBBC038 nuclei microscopy dataset using fixed train–validation–test splits. Robustness was assessed under three types of synthetic perturbations: Gaussian blur, additive noise, and color jitter. Segmentation performance was quantified using the Dice coefficient and Intersection-over-Union (IoU). Paired Wilcoxon signed-rank tests with Holm correction and Cliff’s delta were used for statistical comparison. In addition, clinically relevant nuclear descriptors—nuclear count, median nuclear area, area interquartile range (IQR), and nuclear density—were extracted from predicted masks, and descriptor stability was analyzed as relative deviation from clean conditions. Results: Under clean imaging conditions, Attention U-Net achieved the highest mean Dice score, while paired statistical analysis indicated that U-Net++ exhibited the most consistent performance across test samples. Under image perturbations, Attention U-Net demonstrated greater robustness to blur and noise, whereas U-Net++ showed superior stability under color variations. Descriptor-based analysis further indicated that U-Net++ preserved nuclear count and density most reliably under chromatic perturbations, while U-Net exhibited larger instability in nuclear count and density, particularly under noise. Conclusions: Architectural design choices strongly influence not only pixel-level segmentation accuracy but also the stability of clinically relevant nuclear morphology descriptors. Robustness evaluation under multiple perturbation types reveals important trade-offs between architectures that are not captured by clean-image benchmarks alone. These findings highlight the necessity of multi-level evaluation strategies combining overlap metrics, statistical testing, robustness analysis, and descriptor stability assessment for future benchmarking and clinically reliable deployment of nuclei segmentation systems.

To ensure the cooperative flight of swarm unmanned aerial vehicles (UAVs) with complex constraints and disturbances, a curve tube flight method is proposed, integrating a curve virtual tube planning algorithm with a distributed controller. In the tube planning phase, the signed distance field (SDF) map and enhanced rapidly exploring random tree* (RRT*) algorithm are employed to generate a safe path. Subsequently, the minimum snap trajectory generation algorithm is used to generate the curve virtual tube. To ensure the cooperative flight within the generated tube, a distributed enhanced vector field controller is employed. Within this controller, the outer loop position control utilizes an enhanced vector field control strategy. Meanwhile, the inner loop velocity control adopts an adaptive control strategy based on a learning-based disturbance observer (LDO). Furthermore, this method addresses complex constraints, including velocity, input, safety, and swarm constraints. Finally, simulation and experiment demonstrate the effectiveness of the proposed method for swarm UAVs.

Background and Objectives: Chronic kidney disease (CKD) and maintenance hemodialysis (HD) are frequently associated with psychological distress and impaired health-related quality of life (HRQoL). However, the relationships between depressive, anxiety, and stress symptoms, clinical factors, and HRQoL remain insufficiently understood in routine care. This study aimed to assess the prevalence of psychological distress and to explore cross-sectional correlates of kidney disease-specific and generic HRQoL in Romanian patients receiving long-term HD, providing one of the first detailed characterizations of these relationships in an Eastern European maintenance HD cohort. Materials and Methods: This single-center cross-sectional study included 125 adult patients undergoing maintenance HD for at least one year. Baseline assessment comprised socioeconomic, demographic and clinical and paraclinical data, including Charlson Comorbidity Index (CCI), dialysis adequacy (spKt/V), cognitive function, psychological distress assessed with the Depression, Anxiety and Stress Scale (DASS-21R), and HRQoL evaluated using the Kidney Disease Quality of Life Short Form (KDQOL-SF™ 1.3). HRQoL domains and physical and mental component summary scores (PCS, MCS) were analyzed using descriptive statistics, correlation analyses, and multivariable linear regression. Follow-up assessments at approximately one year were summarized descriptively. Results: Disease-specific HRQoL revealed marked impairment in perceived disease burden and work status, while physical HRQoL was substantially reduced (PCS 36.5 ± 9.6). Mental HRQoL was relatively preserved (MCS 48.8 ± 8.8). At baseline, 48.0% of patients reported at least mild depressive symptoms, 34.4% anxiety symptoms, and 44.0% stress symptoms. spKt/V showed a modest association with PCS. Psychological distress demonstrated weak associations with HRQoL; stress was independently associated with lower MCS, with limited explained variance (R2 ≤ 0.15). Conclusions: Psychological distress is common among Romanian HD patients and is cross-sectionally associated with markedly impaired physical HRQoL. While the present design does not allow causal inferences, these findings support the implementation of routine psychological screening and the consideration of targeted psychosocial interventions in HD care.